Inpatient Psychiatric Facilities Clause Samples

The "Inpatient Psychiatric Facilities" clause defines the terms and conditions under which psychiatric care is provided to patients who require admission to a hospital or specialized facility for mental health treatment. This clause typically outlines the types of services covered, such as room and board, therapy sessions, and medication management, as well as any limitations on length of stay or pre-authorization requirements. Its core practical function is to clarify the scope of coverage and set expectations for both providers and patients, thereby reducing disputes and ensuring appropriate access to necessary mental health care.
Inpatient Psychiatric Facilities. The Contractor shall provide a sufficient number and geographic distribution of inpatient psychiatric facilities to serve the expected enrollment. The transport distance to an inpatient psychiatric facility from the member’s home shall be the usual and customary, not to exceed sixty (60) miles. Exceptions shall be justified and documented to the State on the basis of community standards for accessing care.